Frenectomia labial superior no manejo do diastema interincisal: relato de caso

Abstract

A maxillary midline diastema is a space greater than 0.5 mm between the maxillary central incisors; its persistence has a multifactorial etiology, with the anomalous insertion of the maxillary labial frenum being a notable factor. To prevent relapse and ensure the long-term stability of orthodontic treatment, a frenectomy is indicated as a preliminary step. This study reports the case of a 47-year-old male patient presenting with an aesthetic concern regarding an interincisal diastema associated with a bulky, delta-shaped labial frenum inserting into the interdental papilla. Diagnosis was established via a labial traction test—revealing ischemia of the incisive papilla—and periapical radiography to rule out impacted supernumerary teeth. A maxillary labial frenectomy was performed using a conservative surgical technique involving deep clamping with a hemostat and an incision made over the instrument using a 15C scalpel blade; this maneuver provided temporary mechanical compression of the blood vessels, ensuring intraoperative bleeding control and adequate visualization of the surgical field. A horizontal incision was subsequently made at the mucogingival junction, preserving the band of keratinized gingiva and the interdental papilla. Suturing was limited to the alveolar mucosa. Follow-up at 7 and 45 days showed satisfactory tissue healing, with no dehiscence, infection, or alterations in gingival contour. It is concluded that the conservative surgical technique is safe and aesthetically favorable for removing an anomalous labial frenum prior to orthodontic intervention.